Malformations are abnormal tissue growth formed inside an organ or a vessel, for examples the malformation can be a tumor in liver or uterus or fibroid in the uterus. Malformations can be treated using a minimally invasive treatment in interventional angiography, interventional oncology, interventional surgery, or interventional neuroradiology. For this treatment, a specialist, for example a physician inspects images that had been acquired before the treatment using diagnostic imaging techniques. These techniques can be for e.g. MR (Magnetic Resonance), CT (Computed Tomography) or angiographic acquisitions (X-ray Angiography), either 2-dimensional (2D) images or 3-dimensional (3D) volumes. One way to treat further growth of the malformations is by performing embolization, where the blood-flow to the malformation is reduced or even stopped by introducing an embolizing material into the feeding vessel of the malformation. For diagnosing, the physician needs to find the one or more feeding vessel which supply blood to the malformation. Also in the case of therapeutic procedures for the treatment, the placement of components, e.g. glue, microspheres, catheters etc. has to be placed ideally in the vessel and the injection of the therapeutic materials, for example the embolizing material has to be performed very precisely into the correct vessel.
There are vessels in the surrounding of the malformation which only supply blood to healthy tissue. It is another aim to reduce the number of these vessels from being cutoff the blood supply, since it would harm the healthy tissue. These vessels can be, for example, sub vessels of the main feeding vessel of the malformation. The father away the embolizing material is placed from the malformation itself, the more likely it becomes that many of these sub vessels supplying blood only to healthy surrounding tissue are affected by the treatment. With the currently available systems and tools, the correct placement of the catheter in the vessel to be treated is controlled visually in a contrast-enhanced acquisition with a series of live images during the interventional treatment, usually using a live X-ray image. After inspecting the images, the physician decides the further procedure, e.g. repositioning the catheter or releasing the embolizing material at the current catheter position. After positioning the catheter the physician releases the contrast agent which is deposited in one or more vessel which would be cutoff, as if the embolic material was released at the position of the catheter. This will indicate whether the right vessels are cutoff from the blood supply.
For every required repositioning one or more contrast-enhanced acquisition is made to verify the position of the catheter before releasing the embolic material. This process is repeated usually many times until the catheter is positioned correctly. For a patient undergoing this procedure, many X-ray images are acquired, leading to high dosage of radiation. The said multiple acquisitions taken for the repositioning require the use of a large amount of contrast agent. The high doses of radiation as well as the use of large amounts of contrast agent are not healthy for the patient. The repeated acquisition and analysis of the images to find the correct position of the catheter makes the procedure difficult and time consuming. Hence there is a need for faster treatment and precise positioning of therapeutic material or components, for example a catheter inside the feeding vessels for the treatment, at the same time reducing the radiation doses and reducing the use of contrast agents on the patient.